Individual
STACEY HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2195 BRANDYWYN LN, BUFFALO GROVE, IL 60089-6694
(847) 955-3586
Mailing address
2195 BRANDYWYN LN, BUFFALO GROVE, IL 60089-6694
(847) 955-3586
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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